Complete Back-up Federal Write-In Absentee Ballot

If you requested an absentee ballot but have not yet received it, you can still vote by using the back-up Federal Write-In Absentee Ballot (FWAB).

In order to be eligible to use this back-up ballot, you must:

• You must be a registered voter; AND
• Have applied for a regular ballot so the request is received by your local election official by the State deadline; AND
• Have not received the requested regular absentee ballot from the State.

Indiana allows you to use the Federal Write-In Absentee Ballot (FWAB) for voting in any Federal, State, and local election.

Open Back-up Federal Write-In Absentee Ballot

(Opens in a new window and requires Adobe Reader 7)

What do I fill in?

Only the following blocks of the Voter's Declaration/Affirmation are required:

Block 1: Indiana does not allow you to use this form for registration or ballot request. Do not check the registration box.

Block 2: Select the category that describes you.

Block 3: Name (Last, First, Middle)

Block 4: Date of Birth

Your valid Indiana Driver's License number is required. If you do not possess an Indiana Driver’s License, provide the last four digits of your Social Security number. If you do not possess either of these identification numbers, the State shall assign a number that will serve to identify you for voter registration purposes.

Block 5: Recommended but not required. Provide your contact information to allow your local election official to follow up if more information is required.

Block 7: Complete street address of your Indiana voting residence. A post office box is not sufficient. If your address includes a rural route, describe its location in Block 9. This address must be within the county where you claim legal voting residence.

Block 8: Enter your current mailing address.

Block 9: Provide any information that may assist the local election official in accepting this ballot or application.

Affirmation: Sign and date. No witness or notary required.

Once the ballot is complete, fold and place it in the security envelope and seal. Place only the voted ballot in the security envelope and do not write on the security envelope. Insert the sealed security envelope and the Voter's Declaration/Affirmation into the mailing envelope and seal.

Envelope Templates

Open Security Envelope Template

Open Postage-Paid Envelope Template

(Opens in a new window and requires Adobe Reader 7)

The postage-paid envelope may be used in the U.S. postal system which includes: all U.S. Military Post Offices (APO/FPO) overseas or through the diplomatic pouch available at U.S. Embassies/Consulates

Mail

You must mail your back-up Federal Write-In Absentee Ballot to your local election official. Find your county or city in the address list below to locate your election official.

Open Election Official Address List

Don't know your county? Go to the county finder. Don't know your zip code? Go to the United States Postal Service website.

Fax

If you choose to fax, it is recommended that you fax the form directly to your local election official (fax numbers can be found on Indiana's State Election website). Include ballot, voter affirmation, and cover sheet with secrecy waiver. You may also use our toll-free fax service:

Inside the U.S.? Fax to:
1-800-368-8683
(703)696-2148
DSN 426-2148

Outside the U.S.? Show me a list of toll-free fax numbers.

Open Fax Coversheet

(Opens in a new window and requires Adobe Reader 7)

Email

If you choose to email, email the signed, scanned form directly to your local election official. Email addresses can be found on Indiana's State Election website. Include ballot, voter affirmation, and cover sheet with secrecy waiver. You may also use our Electronic Transmission Service by sending the form as an attachment to ets@fvap.gov.

Open Fax/Email Coversheet

(Opens in a new window and requires Adobe Reader 7)

• Want to submit your Federal Write-In Absentee Ballot by fax or email? Remember that by faxing your voted ballot you are waiving your right to secrecy.
• If using our Electronic Transmission Service, you must use the Fax/Email Coversheet. You must sign the secrecy waiver.
• If you receive your State absentee ballot after submitting your Federal Write-In Absentee Ballot, fill it out and return it. The State absentee ballot will be counted instead of the back-up ballot if it's received in time.